An Anthropological Viewby Kirk W Huffman Thinking About Kava - Part Four

Last Saturday I went for
lunch with friends over to C'an Sort near San Joan, the best place (at least
on Saturdays) on Eivissa/Ibiza for absolutely superb vegetarian/organic food
(and Carol's chocolate brownies, over which wars could be fought). Saturday
lunches there are sort of a gathering of the 'alternative elite' of the island
- a multi-cultural and multi-linguistic meeting in which there are so many people
to talk to about so many things that sometimes there can often be little time
to eat. Bel Fogelberg was there. Bel, originally from Australia, is the last
person on the island to weave a particular type of traditional eivissenc
thick blue-black cloth necessary for certain types of women's' costumes. She
learned the process over 30 years ago, when there were still weavers of this
cloth on the island. Now these weavers are dead and the traditional island black-haired
sheep that provides the wool almost non-existent. Ibicenco women who need this
cloth now place orders with Bel. But when the last black-haired sheep is gone
from the island, what will happen then? I had seen Bel a couple of weeks ago
at a dinner and she had said that she had been suffering from a painful stiff
neck for quite some time. I suggested she try taking kava tablets. Medicinal
kava extract, from the South Pacific kava plant, piper methysticum,
along with its other wonderful properties, can be a very effective natural pain-killer
and is particularly useful for stiffness and aches along the neck and spine
as it works through the central nervous system along the spine. I told her that
because of recent events neither kava tablets nor medicinal extract were
available since January on Eivissa (strange, in an island where just about anything
else is available - one colleague has joked that recent European attempts to
ban kava are probably just about the best way to eventually guarantee
that it sells well on the island!). Bel said she would order it from a mail
service in Guernsey/Jersey that supplies a large segment of the English-speaking
population of the island with quality vitamin/mineral and herbal supplements
at prices much lower than anything on the island. But when I saw Bel at C'an
Sort she told me even these suppliers had told her they no longer provided
kava tablets, even though they were advertised in their catalogue.

This is just another example
of the spreading cancer of 'a ban that does not yet officially exist' but in
fact prohibits people who would benefit from taking extracts of this amazing
plant from doing so. It seems the problem does not lie in the Pacific, where
the kava plant grows, but in Europe - and now the US. According to (often
rather lurid) press reports in Europe and the US, some medical professionals
have hinted there may possibly be a connection between the taking of medicinal
kava extract to relieve anxiety and stress and liver damage. Nothing
like this is known in the traditional kava-drinking cultures of the Pacific,
so if there is some such connection, then it seems possible that it may not
be anything to do with the traditional drink from the plant at all but more
to do with the medicinal extraction/production process for kava tablets
and extracts in 'the modern world'. This would not be the first time that a
perfectly good and useful natural product has been damned by 'modernization'
- and it won't be the last, either. The European and US press-reading public
must already be convinced that kava is 'no good', particularly with such
headlines as 'Out for Kava-Kava' (in Germany, 19th November
2001) and even recent Pacific (particularly Fijian) press reports - copying
the European ones - relating news on '30 cases of hepatitis in Germany and Switzerland',
'24 cases of serious liver disorder in Germany and Switzerland', etc, etc, etc.
The latter certainly puzzled people in Fiji (reaction would be similar in England
if the Daily Mirror came out with a 'Tea found to be responsible for Senile
Dementia' headline), but many of the articles said the news was based upon medical
reports. All of this rather reminds one of the hysterical anti-kava press
campaign in Australia in 1986-7 which had lurid headlines such as ĹKava
takes hold on Aborigines'; 'Kava a Danger to Aborigines says Senator';
'A New Sinister Scourge'; 'Kava: New Poison for Aborigines'; 'Darkness
descends on Milingimbi...and kava flows'; 'Inquiry into Kava';
'Kava Crisis'; 'Aborigines seek ban on 'killer' kava' and so on.

A short aside here is merited.
Australian Aborigines were neither traditional kava growers nor drinkers.
Kava drinking was first introduced to certain aboriginal groups in Australia's
Northern Territory in the early 1980s by Fijian Methodist missionaries there
who saw it as a safe alternative to alcohol. As with the American Indians, alcohol
has been a veritable scourge for Australian aboriginal - neither population
group possess the stomach enzyme necessary for alcohol processing, so they literally
poison themselves with it (approximately 50% of Japanese lack this enzyme as
well and...approximately 4% of European women). For those lacking this essential
enzyme, alcohol can literally kill, and the slightest amount of alcohol in the
system can initiate liver dysfunction and raise liver enzymes in liver function
tests. Medical tests carried out by the Menzies School of Health Research (Darwin)
on chronic heavy-kava drinking aboriginal in Arnhem Land over an 8 month
period in 1987-8 did indicate a slight increase in biochemical indicators of
liver dysfunction, but these returned to normal amongst those who ceased drinking
and the report here states 'there is no evidence of any chronic effects of kava
use on health' after cessation of drinking. Most of the aboriginal involved
in the tests were rather severely undernourished (not as a result of the kava
drinking, it unfortunately seems to be a part of life for aboriginal in that
particular area), which of course may have produced an effect on the results,
and a certain amount of alcohol intake cannot be discounted (although there
was supposed to be none). I should here point out that consuming large amounts
of coffee could produce liver problems amongst susceptible individuals back
here in 'our' side of the world! Kava drinking amongst certain aboriginal
communities certainly eradicated alcohol-induced fighting and violence - one
cannot even feel angry when drinking kava. Kava and anger are
completely incompatible. The frenzy of the Australian press campaign was stunning
in the extreme. Aboriginal groups can consume vast quantities of alcohol and
its effect is devastating. Alcohol sales to aboriginal in certain outback areas
of Australia can be of a regular sizeable amount. Small wonder that some Australians
suspected a certain amount of instigation in the anti-kava press campaigns
by 'elements of the alcohol industry'.

The present series of press
reports is certainly milder than the Australian one of 1986-7, but rather flawed
in a different way. Various figures of reported cases of medicinal kava
extract associated with liver damage in Europe vary from article to article:
24 cases, 30 cases, 60 cases (US), and so on. So one sort of gets the impression
that it's a 'tip of the iceberg' type of problem. There is usually the mention
of one associated death from liver failure, and several liver transplants. No
wonder some people (journalists included) jumped for their writing pens (or
computers, nowadays, I guess). It seems very few have actually bothered to really
dig around to get to the bottom of all this. I have. Things fall into perspective.

If one digs back through
all the material one keeps coming up against the same two or three short medical
reports, all recent, all brief, and all saying that there is as yet no proven
connection between the medicinal kava intake and the liver problems.
It seems there may possibly be one known case in Germany/Switzerland and one
known case in the U.S where kava seems to be the only causal factor.
The other cases seem quite possibly to be of individuals who may already have
had a damaged liver from other causes but who had taken medicinal kava
tablets to relax sometime along the way (and maybe extremely heavy doses at
that). As the kava intake was the 'unknown factor', it is the one that
tends to be pinpointed. This is only correct procedure, though, as medical doctors
must be aware of every possibility and they did the correct thing by noting
it.

However, sometimes things
can get a bit out of hand and reach the heights of insanity. A classic example
is an article in the New York Times of 3rd January 1997, "FDA
Warns That Herb Drinks May Cause Health Problems: Dozens of Partygoers Fall
Ill in California". The report deals with sudden illnesses of 50 teenage
and early 20s (42 were hospitalized) New Year's Eve revellers in one concert
hall who had taken vials of a herbal liquid product known variously as Lemon
fX Drop, Orange fX Rush and Cherry fX Bomb. The vials had labels saying only
one vial was to be taken every four hours and that it was not to be combined
with alcohol or with illegal or over-the-counter drugs. One of the many ingredients
in the vial was kava. When the police were called in they confiscated
10,000 tablets (must have been some party!) and were stoned by the partygoers.
Lieutenant John Weaver of the Los Angeles Police Department said (and I quote
from the report)"people who ingested the substance probably fell victim
to one of its legal and natural ingredients, kava..." Well, surprise,
surprise, as he then goes on to say that some of the revellers had taken as
many as six vials over a short period of time and some had combined it with
Ecstasy, LSD and GBH (a legal intoxicant known as Liquid X). That may sound
like a rather normal night in Ibiza during the summer (from what I hear, residents
don't go much to the nightclubs as they are really for the tourists) but nobody
here would be stupid enough to blame any such upsets on kava!

The US does certainly have
a rather schizophrenic attitude to certain substances, and these attitudes go
in and out of fashion. By 1998 kava was the new 'in thing' in New York,
and whilst I was then a Visiting Fellow at the Metropolitan Museum of Art there,
I noted its progress. I knew it was really 'in' when I saw the colourful front
page of the US 'Sun' magazine for 4th August 1998: "Bible Cures
Revealed! Doctors' new guide to Healing Herbs in Sacred Scriptures" and
just underneath this headline: "KavaKava: Daily dose at
night relieves anxiety". Believe it or not! But I still haven't found the
part in the Bible that mentions kava. What had swung US medical opinion
behind kava were the results of an extensive and extremely detailed 1997
experimental study on kava using 101 patients suffering from anxiety
and tension. The work was carried out over a 25 week period by German scientists
and the positive results (nothing new, of course, to regular Pacific kava
drinkers) hit the American medical profession with an almost audible noise.
At last something really good and harmless has been found! I should here point
out that liver enzymes were regularly checked during the experiments and nothing
untoward was found. News circulated of certain Californian doctors taking some
of their patients off of Prozac and putting them on to kava tablets,
with commendable results. I remember an academic colleague at the Metropolitan
Museum laughingly telling me (in regard to the previous statement) "The
kava producers better be a little bit careful, if it becomes too successful
it will start bothering the big companies and you begin to see indications that
the police suddenly start to take an untoward interest in it!"

Strangely enough, they did
(although I am sure this had nothing to do with the 'big' companies selling
other medicines), resulting in the famous Californian 'kava trials' of
September 2000. There is a rather large Tongan South Pacific community living
in San Mateo county in California and, as in Tonga, the men will often have
a lengthy kava-drinking session in the church grounds after the church
service. One Tongan was arrested by the police for seeming 'drunken driving'
but as the police found no alcohol in him the local public defender got it changed
to 'driving under the influence of drugs'. The police lay in wait outside the
Tongan church in San Mateo county and arrested another Tongan. A trial date
was set and the DA (District Attorney) wanted to prosecute for use 'of an hallucinogenic
substance'. By this time I was a Visiting Fellow at the Australian Museum in
Sydney, but an old school friend in California put me in touch with the defence
lawyer before the trial. Anyone who knows about kava knows that it is
not a hallucinogen (but the prosecution didn't know that, it seems they knew
almost nothing). Kava is neither a hallucinogen nor a stupefacient, although
it is a (mild, non-addictive) narcotic, soporific, analgesic, diuretic, muscle
relaxant, a 'mood leveller', and much, much more. This trial was critical, as
if kava had been shown to be a hallucinogen, then it could be legally
banned. Unfortunately, I do not have my complete 'kava trials' file here
at hand, but I seem to remember that a total of 11 Tongans eventually went on
trial and that 10 were declared 'innocent' and one was declared 'guilty'. But
'guilty' of what, no one seemed to know. 'Guilty of being Tongan', one colleague
laughingly told me. Nothing more was heard after that, and 'hallucinogenic kava'
faded from the press.

Back to the 'Europe-kava-liver'
problem. Many of the actual cases seem to involve individuals with possibly
already-existing liver damage who were then taking kava tablets (sometimes
2-5 times the recommended doses) sometimes at the same time as alcohol and in
some cases 'other substances' possibly as well. The sad but famous case of the
one German 'death from kava-induced liver failure' turns out to be an
81-year-old woman with a long history of alcohol abuse problems. These examples
are taken from what sort of numbers range? If only a few thousand people were
taking these kava medicines then maybe things were not as they should
be if there was any possibility that kava was involved. I decided to
find out. On 14th January I spoke with one of the representatives
of a small German pharmaceutical company (employing 300 people) that produces
and sells three kava extract medicinal products. I was amazed at the
size of the sales market! The company has been producing medicinal kava
extract for over 30 years. During the period 1990 to October 2001 they had sold
40 million daily doses of their major kava product and 23 million daily
doses of their other two kava brands - with no reports whatsoever of
serious adverse side effects. I was stunned, and said so. I was then told that
the biggest share of the market in kava extract sales in Germany was
held by another small company, which had sold 100 million daily doses over the
same period!

So
with sales of that magnitude (and that is only two small companies amongst a
larger number) and if one believed the press reports then just about everyone
in Germany and almost the whole of Europe should now be suffering liver problems.
This is obviously not the case, so there are other factors that are involved
in these 'kava bans'. We will look at these next week. If at times you
have laughed or scratched your head or have become angry at certain points in
this article, wait until next week, this is nothing!